Office of the City Clerk - Record #: O2011-13

Record #:

O2011-13

Type:

Ordinance

Status:

Passed

Intro date:

1/13/2011

Current Controlling Legislative Body:

Committee on Finance

Final action:

2/9/2011

Title:

Loan modification with Wrightwood Senior Apartments

Sponsors:

Daley, Richard M.

Topic:

AGREEMENTS - Loan & Security

Attachments:

1. O2011-13.pdf

Date	Journal Page Number	Action By	Action	Result	Action Details	Meeting Details	Captions
2/22/2011	111688	Office of the Mayor	Signed by Mayor		Action details	Meeting details	Not available
2/9/2011	111688	City Council			Not available	Meeting details	Not available
2/7/2011		Committee on Finance	Recommended to Pass	Pass	Action details	Meeting details	Not available
1/13/2011	110172	City Council	Referred		Action details	Meeting details	Not available

OFFICE OF THE MAYOR

CITY OF CHICAGO

RICHARD M. DALEY

MAYOR

January 13, 2011

TO THE HONORABLE, THE CITY COUNCIL OF THE CITY OF CHICAGO

Ladies and Gentlemen:

At the request of the Commissioner of Housing and Economic Development. 1 transmit herewith an ordinance authorizing the execution of a loan modification agreement for Wrightwood Senior Apartments.

Your favorable consideration of this ordinance will be appreciated.

Very truly yours,

ORDINANCE

WHEREAS, the City of Chicago (the "City"), a home rule unit of government under Section 6(a), Article VII of the 1970 Constitution of the State of Illinois, has heretofore found and does hereby find that there exists within the City a serious shortage of decent, safe and sanitary rental housing available to persons of low and moderate income; and

WHEREAS, the City has determined that the continuance of a shortage of rental housing affordable to persons of low and moderate income is harmful to the health, prosperity, economic stability and general welfare of the City; and

WHEREAS, the City has certain funds available from a variety of funding sources ("Multi-Family Program Funds") to make loans and grants for the development of multi-family residential housing to increase the number of families served with decent, safe, sanitary and affordable housing and to expand the long-term supply of affordable housing, and such Multi-Family Program Funds are administered by the City's Department of Housing and Economic Development ("HED"); and

WHEREAS, pursuant to an ordinance adopted by the City Council of the City of Chicago (the "City Council") on October 3, 2001, and published at pages 67675 through 67685 in the Journal of Proceedings of the City Council (the "Journal") of such date, a certain redevelopment plan and project (the "Redevelopment Plan") for the 79th Street/Southwest Highway Redevelopment Project Area (the "Redevelopment Area") was approved pursuant to the Illinois Tax Increment Allocation Redevelopment Act, as amended (65 ILCS 5/11 74.4 1 et seq.) (the "TIF Act"); and

WHEREAS, pursuant to an ordinance adopted by the City Council on October 3, 2001, and published at pages 67786 through 67794 in the Journal of such date, the Redevelopment Area was designated as a redevelopment project area pursuant to the TIF Act; and

WHEREAS, pursuant to an ordinance (the "TIF Ordinance") adopted by the City Council on October 3, 2001, and published at pages 67795 through 67806 in the Journal of such date, tax increment allocation financing was adopted pursuant to the TIF Act as a means of financing certain redevelopment project costs (as defined in the TIF Act) in the Redevelopment Area incurred pursuant to the Redevelopment Plan; and

WHEREAS, the Project (as hereinafter defined) is located in the Redevelopment Area;

and

WHEREAS, the City Council enacted an ordinance on June 3, 2009, and published at pages 63093 to 63156 in the Journal of such date (the "Original Ordinance") which authorized (i) the provision of Multi-Family Program Funds to 79th Street Limited Partnership, an Illinois limited partnership (the "Borrower"), for the acquisition of land and construction of a building and parking facilities generally located at 2815 West 79^th Street and 2751-2757 West 79^th Street, in Chicago, Illinois (the "Property") for approximately 9 market-rate residential dwelling units and approximately 76 residential dwelling units contained therein as studio, one-, and two-bedroom units for low- and moderate-income families and of certain common areas (the "Project"), (ii) the

designation of the Borrower and 79 Street Development LLC, an Illinois limited liability company ("79^th Street Development", and together with the Borrower, the "Developer"), as the developer for the Project, and (iii) the negotiation, execution and delivery on behalf of the City of a redevelopment agreement with the Developer for provision of tax increment funds for the Project; and

WHEREAS, pursuant to the Original Ordinance, the City made a loan in the amount of $5,887,767 (the "Loan") to the Borrower, on August 25, 2009, with an interest rate of zero (0%) percent per annum, and secured by, among other things, that certain Junior Mortgage, Assignment of Rents and Security Agreement dated August 25, 2009, made by the Borrower in favor of the City (the "Mortgage") (the Mortgage together with the other documents evidencing and securing the Loan are hereinafter referred to as the "Loan Documents"); and

WHEREAS, pursuant to the Original Ordinance, the City and the Developer entered into that certain Wrightwood Senior Apartments Redevelopment Agreement dated as of August 25, 2009 (the "Redevelopment Agreement") for the provision of City Funds (as defined in the Redevelopment Agreement) not to exceed $2,950,000 for the Project; and

WHEREAS, the Project has been completed; and

WHEREAS, the general partners of the Borrower are NHS Wrightwood, Inc., an Illinois corporation (the sole owner of which is NHS Redevelopment Corporation, an Illinois not-for-profit corporation) and 79th Street Development, the sole member of which is 3 Diamond Development LLC, an Illinois limited liability company ("3 Diamond"); and

WHEREAS, at the time of the making of the Loan, the members of 3 Diamond were Ben Klein, Neal Stein and David Porush, as individuals; and

WHEREAS, Neal Stein has relinquished his ownership interest in 3 Diamond (the "Change in Ownership"), and HED wishes to release Neal Stein from his obligations under the Loan Documents and the Redevelopment Agreement; and

WHEREAS, HED has approved a restructuring of the Loan in a manner which (1) will not alter the principal amount of the Loan, (2) will not alter the interest rate on the principal balance of the Loan, (3) will not extend the maturity date of the Loan (items one through three herein referred to as the "Material Terms"), and (4) will consent to the release of Neal Stein from his obligations under the Loan Documents and the Redevelopment Agreement (collectively, the "Restructuring"); now, therefore,

BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CHICAGO:

SECTION 1. The above recitals are expressly incorporated in and made a part of this ordinance as though fully set forth herein.

SECTION 2. The Change in Ownership is hereby ratified, confirmed and approved.

SECTION 3. The Restructuring is hereby approved as described above. The Acting Commissioner of HED (the "Commissioner") or a designee of the Commissioner (each, an "Authorized Officer") are each hereby authorized, subject to approval by the Corporation Counsel, to negotiate any and all terms and provisions in connection with the Loan and the Redevelopment Agreement which do not substantially modify the terms of the Restructuring as described herein. Each Authorized Officer is hereby authorized, subject to approval by the Corporation Counsel, to enter into and execute such agreements and instruments, and perform any and all acts as shall be necessary or advisable in connection with any future restructuring of the Loan which does not substantially modify the Material Terms.

SECTION 4. Notwithstanding anything to the contrary contained in the Municipal Code of Chicago (the "Municipal Code") or any other ordinance or mayoral executive order, no parties other than the owner of the Property as of the date following the date of the closing of the Restructuring (the "Owner"), any legal entities which are direct owners in excess of 7.5% of the Owner which changed in connection with the Restructuring, and all legal entities who constitute the direct or indirect controlling parties of the Owner (as determined by the Corporation Counsel), shall be required to provide to the City the document commonly known as the "Economic Disclosure Statement and Affidavit" (or any successor to such document) in connection with the Restructuring.

SECTION 5. To the extent that any ordinance, resolution, rule, order or provision of the Municipal Code, or part thereof, is in conflict with the provisions of this ordinance, the provisions of this ordinance shall control. If any section, paragraph, clause or provision of this ordinance shall be held invalid, the invalidity of such section, paragraph, clause or provision shall not affect any of the other provisions of this ordinance.

SECTION 6. This ordinance shall be effective as of the date of its passage and approval.

CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT

SECTION I - GENERAL INFORMATION

A. Legal name of the Disclosing Party submitting this EDS. Include d/b/a/ if applicable: 79th Street Limited Partnership

Check ONE of the following three boxes:

Indicate whether the Disclosing Party submitting this EDS is:

1. [X] the Applicant

2. [ ] a legal entity holding a direct or indirect interest in the Applicant. State the legal name of the Applicant in which the Disclosing Party holds an interest:__

3. [ ] a legal entity with a right of control (see Section II.B. 1.) State the legal name of the entity in which the Disclosing Party holds a right of control:_

B. Business address of the Disclosing Party: 7444 N. Long Avenue_

Skokie, Illinois 60U77

C Telephone- ⁸⁴⁷-⁶⁷⁵-⁶⁶⁶⁶ ^x ¹⁰²⁸ Fax- ⁸⁴⁷-³²⁹-⁴⁹⁰⁰ Email- ^dP^orush@^mtsconsulting ^corn

D. Name of contact person: David Pomsh_

E. Federal Employer Identification No. (if you have one): ^26-2330615_

F. Brief description of contract, transaction or other undertaking (referred to below as the "Matter") to which this EDS pertains. (Include project number and location of property, if applicable):

Removal of Neal Stein from ownership of 79th Street Limited Partnership, the owner owner of Wrightwood Senior Apartments project, 28 W. 79th Street, an 85-unit senior mixed-income housing development which was financed with a HOME loan and a TIF grant

G. Which City agency or department is requesting this EDS?^DeP^artment »f Housing and Economic Development

If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:

Specification # ^N/A__and Contract #

N/A

Ver. 09-01-10 Page 1 of 13

SECTION II - DISCLOSURE OF OWNERSHIP INTERESTS

A. NATURE OF THE DISCLOSING PARTY

1. Indicate the nature of the Disclosing Party:

[ ] Person [ ]

[ ] Publicly registered business corporation [ ]

[ ] Privately held business corporation [ ]

[ ] Sole proprietorship [ ]

[ ] General partnership (Is [x] Limited partnership

[ ] Trust [ ]

Limited liability company Limited liability partnership Joint venture

Not-for-profit corporation

the not-for-profit corporation also a 501(c)(3))?

[]Yes []No Other (please specify)

2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable:

Illinois

3. For legal entities not organized in the State of Illinois: Has the organization registered to do business in the State of Illinois as a foreign entity?

[ ] Yes [ ] No [X] N/A

B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:

1. List below the full names and titles of all executive officers and all directors of the entity. NOTE: For not-for-profit corporations, also list below all members, if any, which are legal entities. If there are no such members, write "no members." For trusts, estates or other similar entities, list below the legal titleholder(s).

If the entity is a general partnership, limited partnership, limited liability company, limited liability partnership or joint venture, list below the name and title of each general partner, managing member, manager or any other person or entity that controls the day-to-day management of the Disclosing Party. NOTE: Each legal entity listed below must submit an EDS on its own behalf.

Name . Title

79th Street Development LLC Managing General Partner

NHS Wrightwood Inc Co-General Partner

2. Please provide the following information concerning each person or entity having a direct or indirect beneficial interest (including ownership) in excess of 7.5% of the Disclosing Party. Examples of such an interest include shares in a corporation, partnership interest in a partnership or joint venture,

Page 2 of 13

interest of a member or manager in a limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none, state "None." NOTE: Pursuant to Section 2-154-030 of the Municipal Code of Chicago ("Municipal Code"), the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.

Name Business Address Percentage Interest in the

Disclosing Party

NHS Wrightwood Inc. 1279 Milwaukee, Chicago 0.0051 %

79th Street Development LLC 7444 N. Long Avenue, Skokie 0.0049% RJHOF 8-79th Street LLC 880 Carillon Parkway, St. Petersburg, FL 99.99%

SECTION III - BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS

Has the Disclosing Party had a "business relationship," as defined in Chapter 2-1 56 of the Municipal Code, with any City elected official in the 12 months before the date this EDS is signed?

[ ] Yes [X] No

If yes, please identify below the name(s) of such City elected official(s) and describe such relationship(s):

N/A

SECTION IV - DISCLOSURE OF SUBCONTRACTORS AND OTHER RETAINED PARTIES

The Disclosing Party must disclose the name and business address of each subcontractor, attorney, lobbyist, accountant, consultant and any other person or entity whom the Disclosing Party has retained or expects to retain in connection with the Matter, as well as the nature of the relationship, and the total amount of the fees paid or estimated to be paid. The Disclosing Party is not required to disclose employees who are paid solely through the Disclosing Party's regular payroll.

"Lobbyist" means any person or entity who undertakes to influence any legislative or administrative action on behalf of any person or entity other than: (1) a not-for-profit entity, on an unpaid.basis, or (2) himself. "Lobbyist" also means any person or entity any part of whose duties as an employee of another includes undertaking to influence any legislative or administrative action.

If the Disclosing Party is uncertain whether a disclosure is required under this Section, the Disclosing Party must either ask the City whether disclosure is required or make the disclosure.

Page 3 of 13

Name (indicate whether Business retained or anticipated Address to be retained)

Relationship to Disclosing Party Fees (indicate whether

(subcontractor, attorney, lobbyist, etc.)

Fred Teitelbaum Construction 5526 N. Kedzie General Contractor

paid or estimated.) NOTE: "hourly rate" or "t.b.d." is not an acceptable response.

$14,167,391 (paid)_

Cubellis (now NORR Illinois) 325 N. LaSalle #700 Architect

$556,000 (paid)

Lighten-Gale Group

203 N. Wabash, #608 Financial Consultant

$225,000 (paid)

Applegate & Thorne-Thomsen 322 S. Green St, #400 Attorney

$219,253 (paid)

(Add sheets if necessary)

[ ] Check here if the Disclosing Party has not retained, nor expects to retain, any such persons or entities.

SECTION V - CERTIFICATIONS

A. COURT-ORDERED CHILD SUPPORT COMPLIANCE

Under Municipal Code Section 2-92-415, substantial owners of business entities that contract with the City must remain in compliance with their child support obligations throughout the contract's term.

Has any person who directly or indirectly owns 10% or more of the Disclosing Party been declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?

[ ] Yes [ ] No [Xj No person directly or indirectly owns 10% or more of the

Disclosing Party.

If "Yes," has the person entered into a court-approved agreement for payment of all support owed and is the person in compliance with that agreement?

[ ] Yes [ ] No

B. FURTHER CERTIFICATIONS

1. Pursuant to Municipal Code Chapter 1-23, Article I ("Article I")(which the Applicant should consult for defined terms (e.g., "doing business") and legal requirements), if the Disclosing Party submitting this EDS is the Applicant and is doing business with the City, then the Disclosing Party certifies as follows: (i) neither the Applicant nor any controlling person is currently indicted or charged with, or has admitted guilt of, or has ever been convicted of, or placed under supervision for, any criminal offense involving actual, attempted, or conspiracy to commit bribery, theft, fraud, forgery, perjury, dishonesty or deceit against an officer or employee of the City or any sister agency; and (ii) the Applicant understands and acknowledges that compliance with Article I is a continuing requirement for doing business with the City. NOTE: If Article I applies to the Applicant, the permanent compliance timeframe in Article I supersedes some five-year compliance timeframes in certifications 2 and 3 below.

Page 4 of 13

2. The Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons or entities identified in Section II.B.l. of this EDS:

a. are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from any transactions by any federal, state or local unit of government;

b. have not, within a five-year period preceding the date of this EDS, been convicted of a criminal offense, adjudged guilty, or had a civil judgment rendered against them in connection with: obtaining, attempting to obtain, or performing a public (federal, state or local) transaction or contract under a public transaction; a violation of federal or state antitrust statutes; fraud; embezzlement; theft; forgery; bribery; falsification or destruction of records; making false statements; or receiving stolen property;

c. are not presently indicted for, or criminally or civilly charged by, a governmental entity (federal, state or local) with committing any of the offenses set forth in clause B.2.b. of this Section V;

d. have not, within a five-year period preceding the date of this EDS, had one or more public transactions (federal, state or local) terminated for cause or default; and

e. have not, within a five-year period preceding the date of this EDS, been convicted, adjudged guilty, or found liable in a civil proceeding, or in any criminal or civil action, including actions concerning environmental violations, instituted by the City or by the federal government, any state, or any other unit of local government.

3. The certifications in subparts 3, 4 and 5 concern:

the Disclosing Party;

any "Contractor" (meaning any contractor or subcontractor used by the Disclosing Party in connection with the Matter, including but not limited to all persons or legal entities disclosed under Section IV, "Disclosure of Subcontractors and Other Retained Parties");

any "Affiliated Entity" (meaning a person or entity that, directly or indirectly: controls the Disclosing Party, is controlled by the Disclosing Party, or is, with the Disclosing Party, under common control of another person or entity. Indicia of control include, without limitation: interlocking management or ownership; identity of interests among family members, shared facilities and equipment; common use of employees; or organization of a business entity following the ineligibility of a business entity to do business with federal or state or local government, including the City, using substantially the same management, ownership, or principals as the ineligible entity); with respect to Contractors, the term Affiliated Entity means a person or entity that directly or indirectly controls the Contractor, is controlled by it, or, with the Contractor, is under common control of another person or entity;

any responsible official of the Disclosing Party, any Contractor or any Affiliated Entity or any other official, agent or employee of the Disclosing Party, any Contractor or any Affiliated Entity, acting pursuant to the direction or authorization of a responsible official of the Disclosing Party, any Contractor or any Affiliated Entity (collectively "Agents").

Page 5 of 13

Neither the Disclosing Party, nor any Contractor, nor any Affiliated Entity of either the Disclosing Party or any Contractor nor any Agents have, during the five years before the date this EDS is signed, or, with respect to a Contractor, an Affiliated Entity, or an Affiliated Entity of a Contractor during the five years before the date of such Contractor's or Affiliated Entity's contract or engagement in connection with the Matter:

a. bribed or attempted to bribe, or been convicted or adjudged guilty of bribery or attempting to bribe, a public officer or employee of the City, the State of Illinois, or any agency of the federal government or of any state or local government in the United States of America, in that officer's or employee's official capacity;

b. agreed or colluded with other bidders or prospective bidders, or been a party to any such agreement, or been convicted or adjudged guilty of agreement or collusion among bidders or prospective bidders, in restraint of freedom of competition by agreement to bid a fixed price or otherwise; or

c. made an admission of such conduct described in a. or b. above that is a matter of record, but have not been prosecuted for such conduct; or

d. violated the provisions of Municipal Code Section 2-92-610 (Living Wage Ordinance).

4. Neither the Disclosing Party, Affiliated Entity or Contractor, or any of their employees, officials, agents or partners, is barred from contracting with any unit of state or local government as a result of engaging in or being convicted of (1) bid-rigging in violation of 720 ILCS 5/33E-3; (2) bid-rotating in violation of 720 ILCS 5/33E-4; or (3) any similar offense of any state or of the United States of America that contains the same elements as the offense of bid-rigging or bid-rotating.

5. Neither the Disclosing Party nor any Affiliated Entity is listed on any of the following lists maintained by the Office of Foreign Assets Control of the U.S. Department of the Treasury or the Bureau of Industry and Security of the U.S. Department of Commerce or their successors: the Specially Designated Nationals List, the Denied Persons List, the Unverified List, the Entity List and the Debarred List.

6. The Disclosing Party understands and shall comply with the applicable requirements of Chapters 2-55 (Legislative Inspector General), 2-56 (Inspector General) and 2-156 (Governmental Ethics) of the Municipal Code.

7. If the Disclosing Party is unable to certify to any of the above statements in this Part B (Further Certifications), the Disclosing Party must explain below:

N/A

Page 6 of 13

If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.

C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION

1. The Disclosing Party certifies that the Disclosing Party (check one) [ ] is [x] is not

a "financial institution" as defined in Section 2-32-455(b) of the Municipal Code.

2. If the Disclosing Party IS a financial institution, then the Disclosing Party pledges:

"We are not and will not become a predatory lender as defined in Chapter 2-32 of the Municipal Code. We further pledge that none of our affiliates is, and none of them will become, a predatory lender as defined in Chapter 2-32 of the Municipal Code. We understand that becoming a predatory lender or becoming an affiliate of a predatory lender may result in the loss of the privilege of doing business with the City."

If the Disclosing Party is unable to make this pledge because it or any of its affiliates (as defined in Section 2-32-455(b) of the Municipal Code) is a predatory lender within the meaning of Chapter 2-32 of the Municipal Code, explain here (attach additional pages if necessary):

N/A

If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.

D. CERTIFICATION REGARDING INTEREST IN CITY BUSINESS

Any words or terms that are defined in Chapter 2-156 of the Municipal Code have the same meanings when used in this Part D.

1. In accordance with Section 2-156-110 of the Municipal Code: Does any official or employee of the City have a financial interest in his or her own name or in the name of any other person or entity in the Matter?

[ ] Yes [x] No

NOTE: If you checked "Yes" to Item D.I., proceed to Items D.2. and D.3. If you checked "No" to Item D. 1., proceed to Part E.

Page 7 of 13

2. Unless sold pursuant to a process of competitive bidding, or otherwise permitted, no City elected official or employee shall have a financial interest in his or her own name or in the name of any other person or entity in the purchase of any property that (i) belongs to the City, or (ii) is sold for taxes or assessments, or (iii) is sold by virtue of legal process at the suit of the City (collectively, "City Property Sale"). Compensation for property taken pursuant to the City's eminent domain power does not constitute a financial interest within the meaning of this Part D.

Does the Matter involve a City Property Sale?

[ ] Yes [ ] No

3. If you checked "Yes" to Item D.I., provide the names and business addresses of the City officials or employees having such interest and identify the nature of such interest:

Name Business Address Nature of Interest

4. The Disclosing Party further certifies that no prohibited financial interest in the Matter will be acquired by any City official or employee.

E. CERTIFICATION REGARDING SLAVERY ERA BUSINESS

Please check either 1. or 2. below. If the Disclosing Party checks 2., the Disclosing Party must disclose below or in an attachment to this EDS all information required by paragraph 2. Failure to comply with these disclosure requirements may make any contract entered into with the City in connection with the Matter voidable by the City.

^x 1. The Disclosing Party verifies that the Disclosing Party has searched any and all records of the Disclosing Party and any and all predecessor entities regarding records of investments or profits from slavery or slaveholder insurance policies during the slavery era (including insurance policies issued to slaveholders that provided coverage for damage to or injury or death of their slaves), and the Disclosing Party has found no such records.

_2. The Disclosing Party verifies that, as a result of conducting the search in step 1 above, the

Disclosing Party has found records of investments or profits from slavery or slaveholder insurance policies. The Disclosing Party verifies that the following constitutes full disclosure of all such records, including the names of any and all slaves or slaveholders described in those records:

Page 8 of 13

SECTION VI -- CERTIFICATIONS FOR FEDERALLY FUNDED MATTERS

NOTE: If the Matter is federally funded, complete this Section VI. If the Matter is not federally funded, proceed to Section VII. For purposes of this Section VI, tax credits allocated by the City and proceeds of debt obligations of the City are not federal funding.

A. CERTIFICATION REGARDING LOBBYING

1. List below the names of all persons or entities registered under the federal Lobbying Disclosure Act of 1995 who have made lobbying contacts on behalf of the Disclosing Party with respect to the Matter: (Add sheets if necessary):

None

(If no explanation appears or begins on the lines above, or if the letters "NA" or if the word "None" appear, it will be conclusively presumed that the Disclosing Party means that NO persons or entities registered under the Lobbying Disclosure Act of 1995 have made lobbying contacts on behalf of the Disclosing Party with respect to the Matter.)

2. The Disclosing Party has not spent and will not expend any federally appropriated funds to pay any person or entity listed in Paragraph A.l. above for his or her lobbying activities or to pay any person or entity to influence or attempt to influence an officer or employee of any agency, as defined by applicable federal law, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress, in connection with the award of any federally funded contract, making any federally funded grant or loan, entering into any cooperative agreement, or to extend, continue, renew, amend, or modify any federally funded contract, grant, loan, or cooperative agreement.

3. The Disclosing Party will submit an updated certification at the end of each calendar quarter in which there occurs any event that materially affects the accuracy of the statements and information set forth in paragraphs A.l. and A.2. above.

4. The Disclosing Party certifies that either: (i) it is not an organization described in section 501 (c)(4) of the Internal Revenue Code of 1986; or (ii) it is an organization described in section 501(c)(4) of the Internal Revenue Code of 1986 but has not engaged and will not engage in "Lobbying Activities".

5. If the Disclosing Party is the Applicant, the Disclosing Party must obtain certifications equal in form and substance to paragraphs A.l. through A.4. above from all subcontractors before it awards any subcontract and the Disclosing Party must maintain all such subcontractors' certifications for the duration of the Matter and must make such certifications promptly available to the City upon request.

Page 9 of 13

B. CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPORTUNITY

If the Matter is federally funded, federal regulations require the Applicant and all proposed subcontractors to submit the following information with their bids or in writing at the outset of negotiations.

Is the Disclosing Party the Applicant?

[X]Yes []No If "Yes," answer the three questions below:

1. Have you developed and do you have on file affirmative action programs pursuant to applicable federal regulations? (See 41 CFR Part 60-2.)

[X] Yes [ ] No

2. Have you filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance Programs, or the Equal Employment Opportunity Commission all reports due under the applicable filing requirements?

pq Yes []No

3. Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?

[ ] Yes [Xj No

If you checked "No" to question 1. or 2. above, please provide an explanation:

SECTION VII- ACKNOWLEDGMENTS, CONTRACT INCORPORATION, COMPLIANCE, PENALTIES, DISCLOSURE

The Disclosing Party understands and agrees that:

A. The certifications, disclosures, and acknowledgments contained in this EDS will become part of any contract or other agreement between the Applicant and the City in connection with the Matter, whether procurement, City assistance, or other City action, and are material inducements to the City's execution of any contract or taking other action with respect to the Matter. The Disclosing Party understands that it must comply with all statutes, ordinances, and regulations on which this EDS is based.

B. The City's Governmental Ethics and Campaign Financing Ordinances, Chapters 2-156 and 2-164 of the Municipal Code, impose certain duties and obligations on persons or entities seeking City contracts, work, business, or transactions. The full text of these ordinances and a training program is available on line at www.cityofchicago.org/Ethics, and may also be obtained from the City's Board of Ethics, 740 N.

Page 10 of 13

Sedgwick St., Suite 500, Chicago, IL 60610, (312) 744-9660. The Disclosing Party must comply fully with the applicable ordinances.

C. If the City determines that any information provided in this EDS is false, incomplete or inaccurate, any contract or other agreement in connection with which it is submitted may be rescinded or be void or voidable, and the City may pursue any remedies under the contract or agreement (if not rescinded or void), at law, or in equity, including terminating the Disclosing Party's participation in the Matter and/or declining to allow the Disclosing Party to participate in other transactions with the City. Remedies at law for a false statement of material fact may include incarceration and an award to the City of treble damages.

D. It is the City's policy to make this document available to the public on its Internet site and/or upon request. Some or all of the information provided on this EDS and any attachments to this EDS may be made available to the public on the Internet, in response to a Freedom of Information Act request, or otherwise. By completing and signing this EDS, the Disclosing Party waives and releases any possible rights or claims which it may have against the City in connection with the public release of information contained in this EDS and also authorizes the City to verify the accuracy of any information submitted in this EDS.

E. The information provided in this EDS must be kept current. In the event of changes, the Disclosing Party must supplement this EDS up to the time the City takes action on the Matter. If the Matter is a contract being handled by the City's Department of Procurement Services, the Disclosing Party must update this EDS as the contract requires. NOTE: With respect to Matters subject to Article I of Chapter 1-23 of the Municipal Code (imposing PERMANENT TNELIGTBTLTTY for certain specified offenses), the information provided herein regarding eligibility must be kept current for a longer period, as required by Chapter 1 -23 and Section 2-1 54-020 of the Municipal Code.

The Disclosing Party represents and warrants that:

F. l. The Disclosing Party is not delinquent in the payment of any tax administered by the Illinois Department of Revenue, nor are the Disclosing Party or its Affiliated Entities delinquent in paying any fine, fee, tax or other charge owed to the City. This includes, but is not limited to, all water charges, sewer charges, license fees, parking tickets, property taxes or sales taxes.

F.2 If the Disclosing Party is the Applicant, the Disclosing Party and its Affiliated Entities will not use, nor permit their subcontractors to use, any facility listed by the U.S. E.P.A. on the federal Excluded Parties List System ("EPLS") maintained by the U. S. General Services Administration.

F.3 If the Disclosing Party is the Applicant, the Disclosing Party will obtain from any contractors/subcontractors hired or to be hired in connection with the Matter certifications equal in form and substance to those in F.l. and F.2. above and will not, without the prior written consent of the City, use any such contractor/subcontractor that does not provide such certifications or that the Disclosing Party has reason to believe has not provided or cannot provide truthful certifications.

Page 11 of 13

NOTE: If the Disclosing Party cannot certify as to any of the items in F.l., F.2. or F.3. above, an explanatory statement must be attached to this EDS.

CERTIFICATION

Under penalty of perjury, the person signing below: (1) warrants that he/she is authorized to execute this EDS and Appendix A (if applicable) on behalf of the Disclosing Party, and (2) warrants that all certifications and statements contained in this EDS and Appendix A (if applicable) are true, accurate and complete as of the date furnished to the City.

79th Street Limited Partnership

(Print or type name of Disclosing Party) By: 79th Street Development LLC, its general partner

Dnvld Porush (Print or type name of person signing)

Manager

(Print or type title of person signing)

Signed and sworn to before me on (date) D CCOr^^ 1 Lf 7sO Lp at Coo (<C_County, lUlKo'tS (state).

As^jtfClV\ &dnsi£><U^ Notary Public. Commission expires:_

OFFICIAL SEAL MARGARET M TINUCCI

Page 12 of 13

CITYOFCHTCAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT

APPENDIX A

FAMILIAL RELATIONSHIPS WITH ELECTED CITY OFFICIALS AND DEPARTMENT HEADS

This Appendix is to be completed only by (a) the Applicant, and (b) any legal entity which has a direct ownership interest in the Applicant exceeding 7.5 percent. It is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.

Under Municipal Code Section 2-154-015, the Disclosing Party must disclose whether such Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently has a "familial relationship" with any elected city official or department head. A "familial relationship" exists if, as of the date this EDS is signed, the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof is related to the mayor, any alderman, the city clerk, the city treasurer or any city department head as spouse or domestic partner or as any of the following;, whether by blood or adoption: parent, child, brother or sister, aunt or uncle, niece or nephew, grandparent, grandchild, father-in-law, mother-in-law, son-in-law, daughter-in-law, stepfather or stepmother, stepson or stepdaughter, stepbrother or stepsister or half-brother or half-sister.

"Applicable Party" means (1) all executive officers of the Disclosing Party listed in Section II.B.l.a., if the Disclosing Party is a corporation; all partners of the Disclosing Party, if the Disclosing Party is a general partnership; all general partners and limited partners of the Disclosing Party, if the Disclosing Party is a limited partnership; all managers, managing members and members of the Disclosing Party, if the Disclosing Party is a limited liability company; (2) all principal officers of the Disclosing Party; and (3) any person having more than a 7.5 percent ownership interest in the Disclosing Party. "Principal officers" means the president, chief operating officer, executive director, chief financial officer, treasurer or secretary of a legal entity or any person exercising similar authority.

Does the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently have a "familial relationship" with an elected city official or department head?

[ ] Yes [X] No

If yes, please identify below (1) the name and title of such person, (2) the name of the legal entity to which such person is connected; (3) the name and title of the elected city official or department head to whom such person has a familial relationship, and (4) the precise nature of such familial relationship.

Page 13 of 13

CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT

SECTION I - GENERAL INFORMATION

A. Legal name of the Disclosing Party submitting this EDS. Include d/b/a/ if applicable: 79th Street Development LLC

Check ONE of the following three boxes:

Indicate whether the Disclosing Party submitting this EDS is:

1. [ ] the Applicant

2. [x] a legal entity holding a direct or indirect interest in the Applicant. State the legal name of the Applicant in which the Disclosing Party holds an interest: 79th Street Limited Partnership_

3. [] a legal entity with a right of control (see Section II.B.l.) State the legal name of the entity in which the Disclosing Party holds a right of control:_

B. Business address of the Disclosing Party: 7444 N. Long Avenue_

Skokie, Illinois 60077

C Telephone- ⁸⁴⁷-675.6666 x 1028 p_ax. 847.329.4900 Email- ^dP^orush@^mtsconsulting ^com

D. Name of contact person: David Porush__

E. Federal Employer Identification No. (if you have one): ^26-1502051_

F. Brief description of contract, transaction or other undertaking (referred to below as the "Matter") to which this EDS pertains. (Include project number and location of property, if applicable):

G. Which City agency or department is requesting this EDS? Department of Housing and Economic Development

If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:

Specification # _and Contract # _

Ver. 09-01-10 Page 1 of 13

SECTION II - DISCLOSURE OF OWNERSHIP INTERESTS

A. NATURE OF THE DISCLOSING PARTY 1. Indicate the nature of the Disclosing Party:

Person [X]

Publicly registered business corporation [ ]

Privately held business corporation [ ]

Sole proprietorship [ ]

General partnership (Is Limited partnership

Trust [ ]

Limited liability company Limited liability partnership Joint venture

Not-for-profit corporation

the not-for-profit corporation also a 501(c)(3))?

[]Yes []No Other (please specify)

2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable:

Illinois

3. For legal entities not organized in the State of Illinois: Has the organization registered to do business in the State of Illinois as a foreign entity?

[ ] Yes [ ] No [X] N/A

B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:

Name Title

3 Diamond Development, LLC Sole member

David Porush Manager

Page 2 of 13

. interest of a member or manager in a limited liability company,, or interest of a beneficiary of a trust, estate or other similar entity. If none, state "None." NOTE: Pursuant to Section 2-154-030 of the Municipal Code of Chicago ("Municipal Code"), the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.

Name Business Address Percentage Interest in the

Disclosing Party

3 Diamond Development, LLC 7444 N. Long Avenue, Skokie 100%

SECTION III - BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS

Has the Disclosing Party had a "business relationship," as defined in Chapter 2-156 of the Municipal Code, with any City elected official in the 12 months before the date this EDS is signed?

[ ] Yes [X] No

If yes, please identify below the name(s) of such City elected official(s) and describe such relationship(s):

N/A

SECTION IV - DISCLOSURE OF SUBCONTRACTORS AND OTHER RETAINED PARTIES

"Lobbyist" means any person or entity who undertakes to influence any legislative or administrative action on behalf of any person or entity other than: (1) a not-for-profit entity, on an unpaid basis, or (2) himself. "Lobbyist" also means any person or entity any part of whose duties as an employee of another includes undertaking to influence any legislative or administrative action.

If the Disclosing Party is uncertain whether a disclosure is required under this Section, the Disclosing Party must either ask the City whether disclosure is required or make the disclosure.

Page 3 of 13

, Name (indicate whether Business Relationship to Disclosing Party Fees (indicate whether retained or anticipated Address (subcontractor, attorney, paid or estimated.) NOTE:

to be retained) lobbyist, etc.) "hourly rate" or "t.b.d." is

not an acceptable response.

N/A

(Add sheets if necessary)

[X] Check here if the Disclosing Party has not retained, nor expects to retain, any such persons or entities. SECTION V - CERTIFICATIONS

A. COURT-ORDERED CHILD SUPPORT COMPLIANCE

Under Municipal Code Section 2-92-415, substantial owners of business entities that contract with the City, must remain in compliance with their child support obligations throughout the contract's term.

Has any person who directly or indirectly owns 10% or more of the Disclosing Party been declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?

[ ] Yes [ ] No [X| No person directly or indirectly owns 10% or more of the

Disclosing Party.

If "Yes," has the person entered into a court-approved agreement for payment of all support owed and is the person in compliance with that agreement?

[ ] Yes [ ] No

B. FURTHER CERTIFICATIONS

1. Pursuant to Municipal Code Chapter 1-23, Article I ("Article I")(whicb the Applicant should consult for defined terms (e.g., "doing business") and legal requirements), if the Disclosing Party submitting this EDS is the Applicant and is doing business with the City, then the Disclosing Party certifies as follows: (i) neither the Applicant nor any controlling person is currently indicted or charged with, or has admitted guilt of, or has ever been convicted of, or placed under supervision for, any criminal offense involving actual, attempted, or conspiracy to commit bribery, theft, fraud, forgery, perjury, dishonesty or deceit against an officer or employee of the City or any sister agency; and (ii) the Applicant understands and acknowledges that compliance with Article I is a continuing requirement for doing business with the City. NOTE: If Article I applies to the Applicant, the permanent compliance timeframe in Article 1 supersedes some five-year compliance timeframes in certifications 2 and 3 below.

Page 4 of 13

2. The Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons or entities identified in Section II.B.l. of this EDS:

a. are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from any transactions by any federal, state or local unit of government;

d. have not, within a five-year period preceding the date of this EDS, had one or more public transactions (federal, state or local) terminated for cause or default; and

3. The certifications in subparts 3, 4 and 5 concern:

the Disclosing Party;

Page 5 of 13

c. made an admission of such conduct described in a. or b. above that is a matter of record, but have not been prosecuted for such conduct; or

d. violated the provisions of Municipal Code Section 2-92-610 (Living Wage Ordinance).

7. If the Disclosing Party is unable to certify to any of the above statements in this Part B (Further Certifications), the Disclosing Party must explain below:

N/A

Page 6 of 13

If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.

C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION

1. The Disclosing Party certifies that the Disclosing Party (check one) [ ] is [X] is not

a "financial institution" as defined in Section 2-32-455(b) of the Municipal Code. '

2. If the Disclosing Party IS a financial institution, then the Disclosing Party pledges:

N/A

If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.

D. CERTIFICATION REGARDING INTEREST IN CITY BUSINESS

Any words or terms that are defined in Chapter 2-156 of the Municipal Code have the same meanings when used in this Part D.

[]Yes [_X]No

NOTE: If you checked "Yes" to Item D.I., proceed to Items D.2. and D.3. If you checked "No" to Item D.l., proceed to Part E.

Page 7 of 13

Does the Matter involve a City Property Sale?

[]Yes []No

3. If you checked "Yes" to Item D.I., provide the names and business addresses of the City officials or employees having such interest and identify the nature of such interest:

Name Business Address Nature of Interest

4. The Disclosing Party further certifies that no prohibited financial interest in the Matter will be acquired by any City official or employee.

E. CERTIFICATION REGARDING SLAVERY ERA BUSINESS

_2. The Disclosing Party verifies that, as a result of conducting the search in step 1 above, the

Page 8 of 13

SECTION VI - CERTIFICATIONS FOR FEDERALLY FUNDED MATTERS

A. CERTIFICATION REGARDING LOBBYING

None

(If no explanation appears or begins on the lines above, or if the letters "NA" or if the word "None" appear, it will be conclusively presumed that the Disclosing Party means that NO persons-or entities registered under the Lobbying Disclosure Act of 1995 have made lobbying contacts on behalf of the Disclosing Party with respect to the Matter.)

4. The Disclosing Party certifies that either: (i) it is not an organization described in section 501(c)(4) of the Internal Revenue Code of 1986; or (ii) it is an organization described in section 501(c)(4) of the Internal Revenue Code of 1986 but has not engaged and will not engage in "Lobbying Activities".

Page 9 of 13

B. CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPORTUNITY

Is the Disclosing Party the Applicant?

[]Yes [x]No If "Yes," answer the three questions below:

1. Have you developed and do you have on file affirmative action programs pursuant to applicable federal regulations? (See 41 CFR Part 60-2.)

[]Yes []No

3. Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?

[]Yes []No

If you checked "No" to question 1. or 2. above, please provide an explanation:

SECTION VII- ACKNOWLEDGMENTS, CONTRACT INCORPORATION, COMPLIANCE, PENALTIES, DISCLOSURE

The Disclosing Party understands and agrees that:

B. The City's Governmental Ethics and Campaign Financing Ordinances, Chapters 2-156 and 2-164 of. the Municipal Code, impose certain duties and obligations on persons or entities seeking City contracts, work, business, or transactions. The full text of these ordinances and a training program is available on line at www.cityofchicago.org/Ethics, and may also be obtained from the City's Board of Ethics, 740 N.

Page 10 of 13

Sedgwick St., Suite 500, Chicago, IL 60610, (312) 744-9660. The Disclosing Party must comply fully with the applicable ordinances.

E. The information provided in this EDS must be kept current. In the event of changes, the Disclosing Party must supplement this EDS up to the time the City takes action on the Matter. If the Matter is a contract being handled by the City's Department of Procurement Services, the Disclosing Party must update this EDS as the contract requires. NOTE: With respect to Matters subject to Article I of Chapter 1-23 of the Municipal Code (imposing PERMANENT INELIGIBILITY for certain specified offenses), the information provided herein regarding eligibility must be kept current for a longer period, as required by Chapter 1 -23 and Section 2-154-020 of the Municipal Code.

The Disclosing Party represents and warrants that:

Page 11 of 13

NOTE: If the Disclosing Party cannot certify as to any of the items in F.L, F.2. or F.3. above, an explanatory statement must be attached to this EDS.

CERTIFICATION

' 79th Street Development LLC

(Print or type name of Disclosing Party)

(Print or type name of person signing) Manager

(Print or type title of person signing)

Signed and sworn to before mc on (date) c Cyr^o «y \ U>, ~2<p t Q at C&Ut£- County, \\\ \ nviS (state).

t^iOw^\y^l^W] ^t-C'LAAxZ^i Notaiy Public.

Commission expires:_

OFFICIAL SEAL MARGARET M TINUCCI NOTARY" PUBLIC - STATE OF ILLINOIS MY COMMISSION EXPIRES.02/05/12

Page 12 of 13

CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT

APPENDIX A

FAMILIAL RELATIONSHIPS WITH ELECTED CITY OFFICIALS AND DEPARTMENT HEADS

Under Municipal Code Section 2-154-015, the Disclosing Party must disclose whether such Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently has a "familial relationship" with any elected city official or department head. A "familial relationship" exists if, as of the date this EDS is signed, the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof is related to the mayor, any alderman, the city clerk, the city treasurer or any city department head as spouse or domestic partner or as any of the following, whether by blood or adoption: parent, child, brother or sister, aunt or uncle, niece or nephew, grandparent, grandchild, father-in-law, mother-in-law, son-in-law, daughter-in-law, stepfather or stepmother, stepson or stepdaughter, stepbrother or stepsister or half-brother or half-sister.

"Applicable Party" means (1) all executive officers of the Disclosing Party listed in Section ll.B.l.a., if the Disclosing Party is a corporation; all partners of the Disclosing Party, if the Disclosing Party is a general partnership; all general partners and limited partners of the Disclosing Party, if the Disclosing Party is a limited partnership; all managers, managing members and members of the Disclosing Party, if the Disclosing Party is a limited liability company; (2) all principal officers of the Disclosing Party; and (3) any person having more than a 7.5 percent ownership interest in the Disclosing Party. "Principal officers" means the president, chief operating officer, executive director, chief financial officer, treasurer or secretary of a legal entity or any person exercising similar authority.

Does the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Parmer thereof currently . have a "familial relationship" with an elected city official or department head?

[ ] Yes [X] No

Page 13 of 13

CTTY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT

SECTION I - GENERAL INFORMATION

A. Legal name of the Disclosing Party submitting this EDS. Include d/b/a/ if applicable: 3 Diamond Development, LLC

Check ONE of the following three boxes:

Indicate whether the Disclosing Party submitting this EDS is:

1. [ ] the Applicant

2. [x] a legal entity holding a direct or indirect interest in the Applicant. State the legal name of the Applicant in which the Disclosing Party holds an interest: 79th Street Limited Partnership__

3. [ ] a legal entity with a right of control (see Section II.B.l.) State the legal name of the entity in which the Disclosing Party holds a right of control:_

B. Business address of the Disclosing Party: 7444 N. Long Avenue_

Skokie, Illinois 60077

C Telephone- 847.675.6666 x1028 p_ax. 847.329.4900 Email" ^dP^omsh@^mtsconsulting-^com

D. Name of contact person: ^David ^Porush__

E. Federal Employer Identification No. (if you have one): 26-2574835__

F. Brief description of contract, transaction or other undertaking (referred to below as the "Matter") to which this EDS pertains. (Include project number and location of property, if applicable):

G. Which City agency or department is requesting this EDS?^DeP^artment of Housing and Economic Development

If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:

Specification # ^N/A_and Contract #

N/A

Ver. 09-01-10

Page 1 of 13

SECTION II - DISCLOSURE OF OWNERSHIP INTERESTS

A. NATURE OF THE DISCLOSING PARTY

1. Indicate the nature of the Disclosing Party:

Person

Publicly registered business corporation

Privately held business corporation

Sole proprietorship

General partnership

Limited partnership

Trust

[X] Limited liability company

[] Limited liability partnership

[ ] Joint venture

[ ] Not-for-profit corporation

(Is the not-for-profit corporation also a 501(c)(3))?

[]Yes []No [ ] Other (please specify)

2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable: Illinois

3. For legal entities not organized in the State of Illinois: Has the organization registered to do business in the State of Illinois as a foreign entity?

[ ] Yes [ ] No . [X] N/A

B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:

Name Title

Ben Klein Principal

David Porush Principal/manager

Page 2 of 13

Name Business Address Percentage Interest in the

Disclosing Party

Ben Klein 7444 N. Long Avenue, Skokie 50%

David Porush 7444 N. Long Avenue, Skokie 50%

SECTION HI - BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS

Has the Disclosing Party had a "business relationship," as defined in Chapter 2-156 of the Municipal Code, with any City elected official in the 12 months before the date this EDS is signed?

[ ] Yes [X] No

If yes, please identify below the name(s) of such City elected official(s) and describe such relationship(s):

N/A

SECTION IV -- DISCLOSURE OF SUBCONTRACTORS AND OTHER RETAINED PARTIES

"Lobbyist" means any person or entity who undertakes to influence any legislative or administrative action on behalf of any person or entity other than: (1) a not-for-profit entity, on an unpaid basis, or (2) himself. "Lobbyist" also means any person or entity any part of whose duties as an employee of another includes undertaking to influence any legislative or administrative action.

If the Disclosing Party is uncertain whether a disclosure is required under this Section, the Disclosing Party must either ask the City whether disclosure is required or make the disclosure.

Page 3 of 13

Name (indicate whether Business Relationship to Disclosing Party Fees (indicate whether retained or anticipated Address (subcontractor, attorney, paid or estimated.) NOTE:

to be retained) lobbyist, etc.) "hourly rate" or "t.b.d." is

not an acceptable response.

N/A

(Add sheets if necessary) *

[x] Check here if the Disclosing Party has not retained, nor expects to retain, any such persons or entities. SECTION V - CERTIFICATIONS

A. COURT-ORDERED CHILD SUPPORT COMPLIANCE

Under Municipal Code Section 2-92-415, substantial owners of business, entities that contract with the City must remain in compliance with their child support obligations throughout the contract's term.

Has any person who directly or indirectly owns 10% or more of the Disclosing Party been declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?

[ ] Yes [x] No [ ] No person directly or indirectly owns 10% or more of the

Disclosing Party.

If "Yes," has the person entered into a court-approved agreement for payment of all support owed and is the person in compliance with that agreement?

[]Yes []No

B. FURTHER CERTIFICATIONS

1. Pursuant to Municipal Code Chapter 1 -23, Article I ("Article l")(which the Applicant should consult for defined terms (e.g., "doing business") and legal requirements), if the Disclosing Party submitting this EDS is the Applicant and is doing business with the City, then the Disclosing Party . certifies as follows: (i) neither the Applicant nor any controlling person is currently indicted or charged with, or has admitted guilt of, or has ever been convicted of, or placed under supervision for, any criminal offense involving actual, attempted, or conspiracy to commit bribery, theft, fraud, forgery, perjury, dishonesty or deceit against an officer or employee of the City or any sister agency; and (ii) the Applicant understands and acknowledges that compliance with Article I is a continuing requirement for doing business with the City. NOTE: If Article I applies to the Applicant, the permanent compliance timeframe in Article I supersedes some five-year compliance timeframes in certifications 2 and 3 below.

Page 4 of 13

2. The Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons or entities identified in Section 1I.B.1. of this EDS:

a. are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from any transactions by any federal, state or local unit of government;

d. have not, within a five-year period preceding the date of this EDS, had one or more public transactions (federal, state or local) terminated for cause or default; and

3. The certifications in subparts 3, 4 and 5 concern:

the Disclosing Party;

any "Affiliated Entity" (meaning a person or entity that, directly or indirectly: controls the Disclosing Party, is controlled by the Disclosing Party, or is, with the Disclosing Party, under common control of another person or entity. Indicia of control include, without limitation: interlocking management or ownership; identity of interests among family members, shared facilities and equipment; common use of employees; or organization of a business entity following the ineligibility of a business entity to do business with federal or state or local government, including . the City, using substantially the same management, ownership, or principals as the ineligible entity); with respect to Contractors, the term Affiliated Entity means a person or entity that directly or indirectly controls the Contractor, is controlled by it, or, with the Contractor, is under common control of another person or entity;

Page 5 of 13

c. made an admission of such conduct described in a. or b. above that is a matter of record, but have not been prosecuted for such conduct; or

d. violated the provisions of Municipal Code Section 2-92-610 (Living Wage Ordinance).

7. If the Disclosing Party is unable to certify to any of the above statements in this Part B (Further Certifications), the Disclosing Party must explain below:

N/A

Page 6 of 13

If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.

C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION

1. The Disclosing Party certifies that the Disclosing Party (check one) [ ] is [X] is not

a "financial institution" as defined in Section 2-32-455(b) of the Municipal Code.

2. If the Disclosing Party IS a financial institution, then the Disclosing Party pledges:

N/A

If the letters "NA," the word "None," or no response appears on the lines above, it will be, conclusively presumed that the Disclosing Party certified to the above statements.

D. CERTIFICATION REGARDING INTEREST IN CITY BUSINESS

Any words or terms that are defined in Chapter 2-156 of the Municipal Code have the same meanings when used in this Part D.

[ ] Yes [x] No

NOTE: If you checked "Yes" to Item D.I., proceed to Items D.2. and D.3. If you checked "No" to Item D. 1., proceed to Part E.

Page 7 of 13

Does the Matter involve a City Property Sale?

[]Yes []No

3. If you checked "Yes" to Item D.I., provide the names and business addresses of the City officials or employees having such interest and identify the nature of such interest:

Name Business Address Nature of Interest

4. The Disclosing Party further certifies that no prohibited financial interest in the Matter will be acquired by any City official or employee.

E. CERTIFICATION REGARDING SLAVERY ERA BUSINESS

_2. The Disclosing Party verifies that, as a result of conducting the search in step 1 above, the

Page 8 of 13

SECTION VI - CERTIFICATIONS FOR FEDERALLY FUNDED MATTERS

A. CERTIFICATION REGARDING LOBBYING

None

4. The Disclosing Party certifies that either: (i) it is not an organization described in section 501(c)(4) of the Internal Revenue Code of 1986; or (ii) it is an organization described in section 501(c)(4) of the Internal Revenue Code of 1986 but has not engaged and will not engage in "Lobbying Activities".

Page 9 of 13

B. CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPORTUNITY

Is the Disclosing Party the Applicant?

[ ] Yes [x] No

If "Yes," answer the three questions below:

1. Have you developed and do you have on file affirmative action programs pursuant to applicable federal regulations? (See 41 CFR Part 60-2.)

[]Yes []No

3. Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?

[]Yes []No

If you checked "No" to question 1. or 2. above, please provide an explanation:

SECTION VII- ACKNOWLEDGMENTS, CONTRACT INCORPORATION, COMPLIANCE, PENALTIES, DISCLOSURE

The Disclosing Party understands and agrees that:

Page 10 of 13

Sedgwick St., Suite 500, Chicago, IL 60610, (312) 744-9660. The Disclosing Party must comply fully with the applicable ordinances.

D. It is the City's policy to make this document available to the public on its Internet site and/or upon request. Some or all of the information provided on this EDS and any attachments to this EDS maybe made available to the public on the Internet, in response to a Freedom of Information Act request, or otherwise. By completing and signing this EDS, the Disclosing Party waives and releases any possible rights or claims which it may have against the City in connection with the public release of information contained in this EDS and also authorizes the City to verify the accuracy of any information submitted in this EDS.

E. The information provided in this EDS must be kept current. In the event of changes, the Disclosing . Party must supplement this EDS up to the time the City takes action on the Matter. If the Matter is a contract being handled by the City's Department of Procurement Services, the Disclosing Party must update this EDS as the contract requires. NOTE: With respect to Matters subject to Article I of Chapter 1-23 of the Municipal Code (imposing PERMANENT INELIGIBILITY for certain specified offenses), the information provided herein regarding eligibility must be kept current for a longer period, as required by Chapter 1-23 and Section 2-154-020 of the Municipal Code.

The Disclosing Party represents and warrants that:

F. 1. The Disclosing Party is not delinquent in the payment of any tax administered by the Illinois Department of Revenue, nor are the Disclosing Party or its Affiliated Entities delinquent in paying any fine, fee, tax or other charge owed to the City. This includes, but is not limited to, all water charges, sewer charges, license fees, parking tickets, property taxes or sales taxes.

Page 11 of 13

NOTE: If the Disclosing Party cannot certify as to any of the items in F.l., F.2. or F.3. above, an explanatory statement must be attached to this EDS.

CERTIFICATION

Under penalty of perjury, the person signing below: (1) warrants that he/she is authorized to execute this EDS and Appendix A (if applicable) on behalf of the Disclosing Party, and (2) warrants that all certifjcations and statements contained in this EDS and Appendix A (if applicable) are true, accurate and complete as of the date furnished to the City.

3 Diamond Development, LLC

(Print or type name of Disclosing Party)

By:

David Porush

(Print or type name of person signing)

Principal/Manager

(Print or type title of person signing)

Signed and sworn to before me on (date) OfC £-fV-(>e/ I L?_i ~&?[0 at Co&fc-_County, 1 \\\vvjD\ <s (state).

lAJh-UUn* 0 friO d><AAAstjeWA Notary Public.

Commission expires: 2~- S " ~L<V \ "2-

Page 12 of 13

CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT

APPENDIX A

FAMILIAL RELATIONSHIPS WITH ELECTED CITY OFFICIALS AND DEPARTMENT HEADS

Under Municipal Code Section 2-154-015, the Disclosing Party must disclose whether such Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently has a "familial relationship" with any elected city official or department head. A "familial relationship" exists if, as of the date this EDS is signed, the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof is related to the mayor, any alderman, the city clerk, the city treasurer or any city department head as spouse or domestic partner or as any of the following, whether by blood or adoption: parent, child, brother or sister, aunt or uncle, niece or nephew, grandparent, grandchild, father-in-law, mother-in-law, son-in-law, daughter-in-law, stepfather or stepmother, stepson or stepdaughter, stepbrother or stepsister or half-brother or half-sister.

Does the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently have a "familial relationship" with an elected city official or department head?

[ ] Yes [X] No

Page 13 of 13

GITY OF CHICAGO ECONOMIC 'DISCLOSURE STATEMENT AND AFFIDAVIT

SECTION I - GENERAL INFORM ATION

A Legal name of the Disclosing Party svbmit]u^g.''this. EDS. include d/bVaAif applicable: NHS Wrightwood Int.

Check ONE of.the following three boxes:

Indicate whether/the Disclosing Party submitting this EDS is: 1. ;[ ] .die'Applicant OR

2-. L/j a legal entityhblding £ djre,ct or $djre'c^.inte/r>§t irt the Aibpiicarit: State -the legalname of the:

Applicant in which the bisclbsw£Party holds an interest: ;fon'Street limited Partnership. _

"<>R

3; [ ] a legal entity Ay j th a right of control (see Section.ti.jj. 1,)- State the lega j ham^ of the entity in which the. Disclosing Party 'hdlds a right of control:_

B. Business: address ^f th^DisclpsingP^rty: 12?9 Milwaukee Ave,_

Chic>.gp/!L606'22'

(773).341-3174 (7.73) 329-4-120 ....., ddixbh@hhschicago.org

G. Telephone: ■ ' " '. _Fax:,' " ' _Email:-,

. . DebbrahL. Dixon

D. Name ofcohtactperson: - '- __:

E. Federal Erhpioyer ldehtificatioh No (if you have one):_ _. _ .....- .

P, Brief description io| contract, transaction prother. undertaking (referred to'belowiarthe ''Matter¹') to jWKieh this EDSpertaijis. (Include project number and location' of'.property,, ^applicable):_ ■ Withdrawal bfrfeal Steiri-frbm the 79th, Street Limited Partnership ownersriip: In the Wrightwood Senior Apartments project; 2815 W. 79th Street, ap 85=iiiiit sehiV^'^dHncpmB hciufeirig development wriich was financed with a HOME Ipah and a. Tip granL

. Depaftrnent pfHptisIng and'EcpnbiTiic DeyeJopmsh :<j. Which - City agency or department is requesting this EDS? ^:_ ' ' ' ' .

If the. Matter is ,a contract being hahdled'hy theory's Deparfrnerit of Procurement SerAficeSjiplease complete the following:

Specification #,_andCpntracl _

'Ven .69^6^ 10

Page |. of 13'.

SECTION H -- piSCLOSLHE OF OWNERSHIP INTERESTS

NATURE OF THE.i>iSCLO$iNO PARTY

J Indicate the natureuxf the Disclosing:Paf [ ], Person

X ] Publicly; registered^ businiess'cbrpor'atibn |/I Privately held business. corporation [ ]. Sole proprietorship [.]' GenerBl'paruiership [ j^'Limited'paMership t] trust

[ ] Limited liability'company

'[ j ''Limited liability partnership.

[.] Joint venture

[ ] Not-for-profit corporatiph

(is the not-for-profit corporation also a 501 (c)(3))?;

I] Yes ' [ ] No

[ ] Other (please specify)

2; For legal entities, the' state (or foreign^cpuhri-y) of ihcprpbratibh or orgaiuzation; if appiic.able:, IIHnois

.3., For legal entities nonorganized, in the State of Illinois: Has the¹ organization registered¹ to do business in the $tate of Illinois as a fofeign eptity?

[ ] Yes fj/N6 I/] N/A

B. IF THE DISC LOSING PARTY ISA LEd A'L ENTITY:

1; List below the full,nariie's and ititii&pf aH executive'officers and ₁allidi'i^dtp^s'.pf tb&entity. NOTE: iFp'r not-for-profit corporations^ ajsb list below all members, if any,- which are legal entities-, if there are no such members,, write ''naiijeibbers.'¹' Tor trusts, estates, or lOther similaj'entities, list bel'dw the legal Utleholdei'(s).

|f the "entity is a geheralptfrtijershipilirtiited partnership',, limited diabij^ry^.eompanyi'^iiniteci liability partnership or joint venture, list below the name and title of each gcncral partn'cr,, managing, m^ manager braiiy'Other, person or 'ehu^y thattcohtrbls the 'day4to^.d"ay#ainagem6ht of the p'iselosing Party. NOTE: iBaj&'b/leg'aX'Qfttjiy'Ji^ted below must submit,an £DS.on its owh behalf.

Name 'Title

>Debbra'h LDIxori Pr«idehtn"ireasurer

James K. Wheatori Vice Rr^ident/A»istarit Seccetaiy

Robin goffey,'_ Secretary__

2. Please provide the following information concerning each fte/ijori. or entity having a direct/or¹indirect Beneficial interest (including ownership) in. excessi of 7.5% of the Disclosing Party, Examples of such a n interest include shares iiri a,corporation,, partnership interest, in a partnership P,r jOmt venture;.

Page 2 of 13

interest of a member or manager in a limited liability company^ or interest of a beneficiary p'f a tnisU estate or other simMaT entity. If hone, state "None." NOTE; pursuant to Section 2-15.4-f)30 bf the MumcipalCode of ehjcagOi("Municipal -(po'de"),- the Gify may require any such-additional information from any 'applicant' which is reasonably intended to achieve. full disclosure'.

Name Business Address Percentage Interest in the

Disclosing Party

NHS RBdevel6pneni;earp,oratipn 1279 N. MHwuakee Aye., 5tri F|...6h|cagp,_:6_rp622 1 00%

SECTION UI -- BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS

Hasthe Disclosing Party had a "business rel.atip'nsh'ip," as defined in Gha'p'ter 2-1 56"of die Municipal 'Code, with any City Elected official iirthe 12 months before the date this EDS is signed?

,[]Yes 'L/No

If yesVplease identify belp.w th describe such

fclatidnship(s):.

SECTION IV _r DISCLOSURE dF SUBCONTMCTORS ANDOTHER RETAiNEp PAJRTIES

The Disclosing Party must ^scl^c-thcVxAme and b^'incss-'addres.s■'bf eac&,subCo,ntraclpr, attorney,, lobbyist, acdouniant, consultant and any other persph or entity whom tlie.Disclbsing: Party has retained pT'expects to retain in connection with the Mattcr,:as well as the nature of the relationship, and the total¹i.amount of the fees paid or estimated to^;be paid, t he Disclosing Party is holt required lodi6cjose lemployees who. are paid solely thrpugh the Discipslhg Partes regular payroll;

^Lobbyist" means any person or entity who undertakes to influericeany legislative Or'administrative action on behalf pf any person or entity other than: (1) a hot-forTprofit entity, pri an u npaid basis, of (2), himself , "Lobbyist" also means any person or entity any part of whose duties as an cmployce.of another includes undertaking to Influence any legislative or''adminis,tradyc action,

if the pisciosihg Party is uncertain whether a disclosure is required under this Section, the Disclosihgfcariy must e.ifh.et.<a$k the City whether disclosure is required or make the disclosure.

Page 3 of 13

Name (indicate whether Business Relationship tq Disclosing Party Fees (indicate Whether retained or anticipated Address (subcontractor, atforiieyi paid or'estimated;) NOTE:

.to be retained) lobbyist^etc.) "hourly rate" or':!t.b.d."'is

not an acceptable response.

(Add sheets if necessary)

:L^,:Che,ck here _;ifthe Disclosing Party ha$ not retained;, hlor expects to retain,; any such persons or entities. .SECtiON V ~ GERTIFI0ATIONS

A, COUREORDERED CHILD SUPPORT COMPLIANCE

Under Mun icipal Code Section 2-92-415,, subsjantial owners of business entitiesthat contract With the, City must remain in<compliance' With their child suppbrt ob.hgatioris throughput the contract's lerin.

Has.any person who directly or indifecQy^pwIis:or'more 6f tfi.e'Piscjo.Mhg'Pkrty'bee'n: declafediiri arrearage"oti My ^!c.hild.-support- obligations by any Illinois court of competent jun'sdictipn?

'[i']'Yes [ ] No No-person directly or indirectly'pwns 10% or more of the

Disclosing Party:

IfVYes/' has the person entered agreement for payment of allsupport pwe^and

is.thc person'.in c&'ih/p^i'aftc.e^,'*'ith: that agreement?

[ ] Yes [ ] No

B, FURTHER CERTIFICATIONS

i: Pursuant to Municipal Code Chapter J -23, Article I ("Article l");(which the: Applicant should consult for defined termsXe.'g,, "ddingbusihess'') and legal requirements),, if the Disclosing Parly submitting this)EDS is the -Applicant arid is. doing business withithe City, then the Disclosing Party certifies\%s follows: (i)'neithcr die Applicant nor,any controlling person is Currently indicted or charged with; or ha's.admiUe.d;.|uiltkt_}.err has dyer bech'convicted of* or placed Uhder ;SUpervisiqii for; any criminal offenselirtyoivjhg actual, attempted, or,conspiracy tq.0.ntJj)itbribery; .theft,.-'fra'pd,'fqrgei$ perjury, dishonesty or.'d'eccit against an officer or employee.-of fbeCity or a'ny sister agency;'arid (ii);thc Applicant understands and acknowledges that cqmpliatice .with Article I is ai continuing r,equherheht'fbr doing business with die. City. NOTE: If ArticleI applies to the Applicant, the permanent compliance timeframe in Article Lsupersedes some.five-y'6ar cjbm.pliancjs--tim^fTames-iin certifications 2 and 3 heloW._:

Page4;of 13'

2. The Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons of entities identified in Section Il.B.l. 6'f this EDS:

a. are not presently debarred', suspended, proposed for deb arm eh t, declared ineligible qrvphmtariiy excluded from any transactions by ariy federal,-state of local.unit of government;.

b. have notj within a fiverye^? j>efrdd- preceding the dale of this EDS, been convibted'pf a; crimihal offense, adjudged guilty, prhada civil judgment rendered against-diem,ih - c«imection with: obtaining, aUefnpting to obtain, or pe^b^in^.apu^]ic/(fedef°al, state or local) transaction or contract under a public transaction; a violation of federal or State- antitrust .statutes;-fraud';. embezzlement; tbc|t; forgery; bribery; falsification or¹ destruction of records;- making, false statements; or receiving stolen property;

c\ are not presently indicted for, or criminally of civilly charged by, a govern mental entity (federal state or local) with committing any of the offenses) set f6ri'h^)n.dause.B'.2:b';-Qfthi'^ .Section* V;,

d-i have not, Within a five-year period preceding theida.t'C: of this Ep^bacj one-or mp.rC public, transactions ^ default; and'

,c>. have not, within -a- five-yfearp'eriod preceding, the. date of this EpS^b'ee.ri convicted^ adjudged guilty; or found liable in a .civil proceeding, pr in apy criminal or civil actipn; jncludin concerning environmental violations, instituted by the City or by the- federal government, any state, or any other unit of local government

3. The certifications in subparts % A and .5: concern: ■ the Disclosing Party;

r any -'Gpniraetor" (meanihgariycontractor orsubcontractqr-usedby'the Disclosing Party jri connection with the Matter(iincluding<but-npt limited to all persons Or leg'ai^nti1jes''.d]sc)p°sed'under

' Section IV^ "Disclosure of Supcpnrractors arid O'ther Retained Parties"); any " Affiliated Enti ty'¹ (meaning a person .or entity thati directly or-'indirectly; cqntrdlS'the Disclosing Party, is cpritroll^ orI is-. With (he Disclosing Party, under

■ common-contra,! pf another person or entity , indicia of control .include^ Vithoiif liriitation: interlocking management ofr ownership; i'dehdtyof interests among family Members; shared facilities aha equipmehtji Cprhmon use of employees; or organization of a business'entity following the ineligibility .of :a-business entity to dp busihess w ilb; federal' or state or local gdvermrjeiit, including the City:, using siibstaiitiaiiy the saThe.manageihenf, ownership^, or principals as the ineligible entity);, with respect to'- Contractors, the- term AFfi Jiafcd Entity means a person: or entity that directly or indirectly controls the Contractor, is cbntfq.Uod byil_r«or, with the-Contractor,, is Undep common control of another person or entity;

any, responsible official'pf the Disclosing Party, any Contractor or any-Affiliated Entity or any qtherofficia'l; agent or employee of the Disclpsing Partyi any Contractor-or any Affiliated,Entity^ 'acLirig pursuant to die direction or authorization'of a responsible; official of the Disclosing Party; any Contractor Or any' A ffiliated'Entity (collectively "Agents"):

Page 5 of 13

Neither the Disclosing Party, nor any Contractor, nor any. Affiliated Entity of either the Disclosing Party or any Contractor nor any Agents haye,_:!during.'the five years before the date)this'EDS' is sighed, or_tj with respect to a Contractor,, an Affiliated Entity,, or an Affiliated' Entity of a Contractor during the five years before the date ofsuch Contractor's or AffUiated Entity's: contract or engagement in connection with the Matter:

a; bribed ppartempieditQ^brib^.'or beeti convicted or adjudged guilty of bribery'or attempting to bribe;, a public officer or employee of the City, thciState of.Illinois^ pr any agency of the federal: government or of any state or Ideal, government in the Urijlcd Stales of America, in thai officer's of employee's official capacity;

b. agreed or coljudedwith' other bidders or prospective" bidder?, or bc.cn a party to any such agreement, Ofbeen convicted orildjudged 'guilty- of agreeniept or 'collusion: among bidders,6r prospective bidders, in restraint of freedomof 'competition byagreeniept to bid a fixed price ,or-pthcrwise; or

c. made'an admission ofsuch conduct'described, jn- a-, or b, above; that is a mattcf'pf record,, but have not been ,prosecuted for such conduct;',or

d. violated the provisions of Munjeipat Code Section 2-92-610;(Living Wage Ordinance),

4. N either the Disclosing Party, Affiliated 'Entity' Or Contractor, or any of their employees., officials-agents pr partners, is barred fronr contracting with -any unit of state or Ipcai gbyerhment as a, result of -eiigagihg'in or being convicted 6f(J.)bid** jgging.in violation, of 720 ILCS 5./33 BO-;\2),hid-rptating ijv Violation of 720 ILCS5/33Er4; Of (3) any similar offens^ of any state or of die United States of Ame'rica that contains the sam9.cicrhc.nts as the offense pfbid-rigging or bid^rpuMirig;

5: Neither the Disclosing- Party hpr any Affiliated Entity is listed on anyqf the following lists niaihtaihedby the Office of Foreign Assets Contrpj of the' U.'S, Dep^tment of thef rPasufy or. the; Bureau of Industry and Security of the JJ.S, Department of Cbmmerce or their successors: the specially Designated Nationals List, the Denied Persdns List; mc;Uhycrific;d:List, the, Entity List and the Debarred/List,

6. The Disclosing Party, understands and shall comply with'the' applicable, requirements of Chapters 2-55 (Legislative Inspector General), 2-5(5/(inspector General) and 2-15(5'(ppyernmerilal Ethics) qf the Municipal Cp.de.

7, If the Disclosing Party is".unable to certify to any^fpf^;the,-above statements in this Part B (Further Certificatipris), the Disclosing; Piarty inust explain below:

Ki/a'

Page 6 of 13'

Jf the letters "NA,¹! the word ''None," or hp response appears bn<tbedin#ab.oy«,,'it'"will_:be;conclusively presumed tfta'tth'tf Disclosing Party certified! (othe abpye statenieriis.

C: GER T j PIC ATION OF STATUS AS FINANCIAL iNSTITUTiON

1: The Disclosing Party certifies tbatthc Disclosing Party (checi: tine)

[ ] is lis not

a "financial institution" as defined in Section 2-3 2f455(b)-of the Municipal Code.

2 : if ilic D isclosing'Party IS a finahciaLihstity tipni then the Disclosing party pledges:¹

''We are-not art'd will not be.cbme'a predatory lender as defined iii Chapter 2-32 of the Municipal Code. W? further pledge that n.Pne-qf our affiliates is^ and nphcpf then? will becpniCi a predatory ifender as defined ih Chapter 2-32 of the Municipal Code. W.e .understand that becoming a_:p.redatpry lender or. becoming an affiliate of a predatory lender may result in the ldssvpf the privilege .pf doing business ^yith the'City."

If the.Diselosing Party is unable to make this pledge because it or 'any' of its affiliates |as! defined* in Section jr3'i-455(b> df'the; Municipal Code) is a predatory'lender within the- meaning of Chapter -2-32 pf the Municipal Code, explain here (attach additional pages; if necessary):

N/A _'__ ... '■_.'". _

If the letters "NA:"the word."None," or no response-appearsoh the lines above,:it will be 'Con'clusiVely-preium^-m'at the Disclosing Party certified¹ to the: above, statement^;

D. CERTif 1CATION REGAPypJLNG INTEREST lN 'CilTY BU SINESS

Any¹ words or terms, that are defined ui Chapter 2> 156 of the Municipal) Code .have' the iarne me^iiigs wh^n used'in this Part D.

1. Ih«apcprd.arice with Sectibn"2-.lo6> 1*J0 'of the Municjpal'Cdiie: Does;any official or ehiplbjee of the City have a financial interest in his or her own name or ih the name \6f Any other persbn or entity in the Matter?

[ ] Yes. LVfNo,.

NOTE':, If you cheeked' "Yes" to Uern D.J,, proceed to l.tems D',2:,aiid D'.'3■. If ybu. chepked *^lNp'* to 'Item D.-lp.rpceed;t6 Part Ei

Page 7. of 13'

2. Unless sold pursuant to .a process of competitive bidding; or otherwise permitted, no City ejected 'official Or employee shall have a financial interest in his or her own name or in the name of any other person or entity in the purchase of any property that (i) belongs to the City,, or (ii) is sold for taies or assessments, or (iii)' is sold hy virtue of legalprpcbss at the suit of the City (^cpllectiycly, "City Property Sale"). Compensation for property'taken pursuant to the City'sVemineht.domain, power does not constitute a financial interest within the meaning cf this Part D:

Does the Matter involve a City Property Sale?

tlVes L^Nq

3. Ifyou checked "Yes" to item D,lprovide thc.names arid busjnpss addresses' of the City officials 6f employees ha ving' such interest and.identify the hature'df such /interest:

fJariie Business .Address Nature of Interest

4'. The Disclosing Party further certifies that no,prohibited financial-interest in the Matter will ■be. acquired by-any City official qrempioyee.

E, CERTIFICATION REGARDING SLAVERY ERA BUSINESS

Pleaset checlc either k Or 2i below'. If the (Disclosing Party checks 2.j the Disclosing- Party must "disclose below or in ah attachment to this EDS all information required by paragraph 2. Failure to. ■comply with-thSse,disolqsu.re.requirements may make-any contrac.t entered iritp With the City in connection with the Matter Voidable by the City.

;*/. ;1: The Disclosing Party Verifies that the, Disclpsing Party has searched, any aiid a [1 records of the Disclosing Party and any .and all predecessor ehhtics regarding fecqrds pf jnyestments or profits tVqm slavery or-"slaveholder insurance policies during the slavery,era.(including insurance policies issued to, slaveholders that provided 'coverage for damage' to or- injury or death -of''their slaves), and the Disclosing Party has fduiidinp.sucb records

2: The Disclpsing Party verifies that, as a'res'ult of conducting fhe search instep l aboye. the Disclosing Party has found fecqrds. of investments or profits from slavery or slaveholder insurance policies. The Disclosing Party verifies that the following constitutes full.d.isclosure q,f all, such records,.inclxiding:thc names Of any and iall slavesiior slaveholdersdescribed in thqse.fccords:

Page 8 of 13

SECTION VI ^ CERTIFICATIONS FOR FEDERALLY FUNDED MATTERS

NOTE: If the Matter is federally funded, complete this Section VI. If. the Matter is not federally funded, proceed to Section VII. For purposes of this Section VL tax-credits ajij.6c.ated. by the City, and proceeds of debt-obligations df the City are not federal funding.

A. CERTiPiOA'f ION REGART51NG LOBBYlNG^!

1. List below the names of allpersohs or entitiesregistered under the federal'Lobbying, Disclosure Act of 1995 who have, made lobbying contacts on'behalf, pf the Disclosing Party-with respect to the Matier: (Add sheets if necessary);

(Ifno explanationappears orbegins on the linssab.oye, or if the letters "NA" Of if the word "None"' appear, it will/be conclusively presumed that the Disclosing Party means that.NO persons or entities registered under the.Lobbying DisclosureAct Of 1-995 have, tnadc .lobbying- cbntac^/on behalf of the Disclosing Party with respect to the Matter.)¹

2. The Disc losing Party: has not speiit and will not expend any federally appropriated'funds to pay-any person or entity lis ted in Paragrapji AJ. above for his or her |dbbying;ach'vkies or to pay any person of entity to ihfluence or attempt to -influence an officer of employee; o f any agency, as defined by applicable federal law, a member of Congress,.mofficer or employee of Congress, or an employee of a member- pf Congress', in connection with the award' pfany federally funded contract,, making any federally funded'grant or loan, entering, into ;any cooperative agreement-, or to extendi cpntinuej renew; amend, or modify any.federally funded contract; grant; lpah_; or-eppperativeagreement.

3'. The,Disclosing Party will submit an updated certification: at the fend 6f each calendar quarter in which there occurs any event that, materially 'affects the accuracy of the statements ;arid information set forth' in paragraphs A.l. and A.2., above;.

4\ The jS.isclpsing Party certifies that either; (j) jt isndt an prganizatibn .descjihfed in section 501 (c)(4) of the In ternal Revenue Code of 1986*; Of (ii) itis_;an pfganizatidn described iii section 50i(c)(4)'of the Internal Revenue.Gdde df 19*8.6'but to"?,ftp.t.engagfe'd and*"wiH npEchgage'in,''Lobbying Acjiyities".

5. If the Disclosing j^arty is the" Applicant, the Disclosing Party must obtain certifications equal in form and substance to paragraphs A.l. through A.4._: above from all subcontractors befpfe it awards any Subcontract and the,Disclosing Party must niairit&in -a.ll--$uch.subcontractors' <&rtifjca-ti6ns forthe durati'dri' of the Matter and must make such certifications promptly available -to the City upon request.

Page 9 of 13

B CERTIFiC.AtioN REGARDING EQUAL EMPLOYMENT-Of^

If the Matter is federally funded, federafregplatibhs and all proposed

subcontractors to submit'the ibiiowing information With their'bids/pr in-writing,;at the/putset of-negbtiatidns't

Is the Disclosing Party the Applicant?

U Yes L/TNo

If I'Yes,*' answer the-three questions below:

1: H$ve you de>elpped and dp you have pn/fi)e affiTmative'action programs pursuant to applicable federal' regulations? '(See 41. CFR Part 60:-2_:); [,!] Yes []Np

2 .; Have ypu>filed with the Joint Reporting Committeej the Director of the-^fTice of Federal Contract Corapiiance programs; of the Equal Employment Oppprtuaily.C'p all reports due;

under th"e^:applicable fding Tequiiements?'

[ ].Yes ['"[No

3. H'aVe you participated¹ in any previous contracts pf .suhcphfracte Subject tp the equal opportunity clause?

1 j Y es [. ] hip/

If ypu checked "No? to question 1. of 2, above,pieasje ,pfoyide;'afi;- explanation:

SECTION VII. _T ACKNOWLEDGMENTS, CONTRACT INCORPORATION^ COMPLIANCE, PENALTIES, DISCLOSURE

The Disclosing, Party understands and; agre.es that:

,-A. the certifications, disclosures; .and"acMpwled'gm'eh.ts cpntajhed in this EDS will beedmeipaft of any-Contract or other agreement between the-Applicant and the City in conncctipn withvtjje Matter, whether procurement,,City assistance, ofotherCity action, and are ifiaterial inducements<to-the City's execution of any contract 0'f taking other action with respect to the Matter The -Disclpsing Party understands that it iriiist cpmply with all statutes, ordinances, and regulation's pri which¹ this EDS is based.

B-, fhe.-City?s.Govemraentaj Ethics.and'Campaign Financing Ordinances,tCh'apiers-;2-i';5.j6--and'IrV^iP¹" the Municipal¹ Code, imposecertain duties and obligations on.persons.or entities seeking City cpntfaetsi work, business, or transactions; The full rext of these ordinances, and'.a training program is available on line at www.cityofchicago.driB/Ethics. and may alsd be dbtaihed irOmthe City's Board 6f'Ethics, 740 N,

Page 10 of 13

Sedgwick St., Suite.500* Chicago, IL m6\&AM2}iMM6ti. The" Disclp'sirrg-Paity must-corapiy fully with the applicable ordinances,

G-. If the; City determines.that any information provided in this EDS is false,, incomplete or inaccurate' any.cbntract or other agreement in connection with which it is submitted may be rescinded or be void er voidable^ and the City may pursue any remedies, under the contract of agreemen.t/(if.npt rescinded of void);-at law}-6r in equity; including terminating the Disclosing 'Party's participation iii the Matter arid/or declining to allow ,thc Disclpsing Party to'participate in-other transactions with the City. Remedies at law for a false statement of mat'ef jaifa'C't may include'incarceration and an .award to the City of treble damages;

p. It Is the City's policy to make this document availabje'tb the public on its Internet site and/of upon irequest: Some of all of the information provided on this ED$ .and any atochments io this EDS may be' made available to the public oh the Internet, in response to a' Freedom of'Information Act request, or otherwise; By completing and signing this EDS,, the Disclosing Party waives and releases: any possible: rights or claims which- it may have against the City in connection with the^public release pf information, cpniamcd in .this'EDS arid also authorizes the City-to; Verify the accuracy of any information submitted in this EDS.

E'The information provided in this EDS must be kept current. Iii the event, of change's; the Disclosing Party rriushsupplehicnt this; EDS up to the time the City- takes action oh.me Matter If the;Mattef is a contract being handled by the City's DepartmentpfPio'tufetnthi .Services, the Disclpsing Party must update this EDS' as the contract requires NOTE: With respect to Matters subject to Article; j-pf 'Chapter-1-23 of the Municipal Code (imposing PERMANENT J N EL1G1B1L IT Y for certain .specified offenses), the information¹ provided herein regarding eligibility -must'be kept current for a longer period, as required by Chapter 1-23 arid Section2-i54-Q2fj'of die Municipal Cpde.-

the Disclosing Party represents and warrants that:

F;i > the Disclosing Party, is not delinquent in the payfreht pfany tax a^dni'ihi'stered by the jUinoi's Department of Revenue, nor- arc the Disclosing Party or its: Affiliafed Entities delinquent in paying any fine, fee,, tax or other charge owed to the City., This includes,,but is n^fpt lirnited^:toall watcrCihargeSi, sewer Charges, license fees', parking tickets; property taxes or sales .taxes.

i\2 If the Disclosing Party is the Applicant^ the Disclpsing Party a.n£its-AffiliatedEntities'will-ribl use;.jio't^ermit theirsubcOntractprs' to use, any facility listed by tbe XLSV -E-.P.A. on- the; federal Excluded¹Parties List System ("EPLS") maintained by thfc.U. S: General Services.A^ministo'tjoii.

F,:3 If the Disclpsing Party is the Applicant;,, the Disciosihg-Parfy will obtain from any cdhtractors/subcontracldrs hired of to be hired ihicdnriectipn with the Matter certifications equal in form and substance to those iii- F.l;. and F.2, above and will not^ without the prior'Written, consent of the City, use any such eohtractpf/sub.cpn^ nOt prqyide such .certifications or. that the

Disclpsing Party has reason to beUcye has iiO,t'provided6i cannot providetiiithfpi certifications.

Page. H qf 13

NOTE: If the Disclosing Party cannot certify as to any of the items in F.l., F.2. or F.3. above, an explanatory statement must be attached to this EDS.

CERTIFICATION

Under penalty of perjury, the person signing below: (1) warrants that he/she is authorized to execute this EDS and Appendix A (if applicable) on behalf of the Disclosing Party, and (2) warrants that all certifications and statements contained in this EDS and Appendix A (if applicable) arc true, accurate and complete as of the date furnished to the City.

NHS Wrightwood Inc.

(Print or type name of Disclosing Party)

James K. Wheaton

(Print or type name of person signing) Vice President

(Print or type title of person signing)

Signed and sworn to before me on (date) 12. - /ia - £6f O

at (LcnL County, "LL

(stale).

Notary Public.

Page 12 of 13

CiTY OF .CHICAGO ECONOMIC DISCLOSUREi£tjVfEMENtAND AFFIDAVIT

APPENDDC A

FAMILIAL RELATIONSHIPS WITH ELECTED CITY OFFICIALS AND DEPARTMENT HEADS

This. Appendix is to be completed only by (a) the Applicant, and (p) any legal entity which has a direct ownership interest in the Applicant exceeding 7'-5 percent. It is: not to be completed I by any legal entity which has only an indirect ownership interest in the Applicant.

Under Municipal Code Section 2-154^015; the Disclosing Party must disclose whether such Disclosing Party pf .any "Appiicablc Party" of any Spouse or Domestic Partner thereof ciirrentiyhas' a -^<(ian^lialirela^s^ip'^t:With' any elected city official 6r department head, A "famibal relationship" exists if, as of the date. fbis_: EDS Ss' signed.the Disclosing Party or any "Applicable Party⁵' orariy Spouse of Domestic Partner thereof is related 'to the mayor? any aldcrmarif the City clerk, the city treasurer or any city department head as spouse or. domestic partner oras any of tiie foil owing, whether by blood or adoption: parent, childy brother or.sistef, aunt or uncle,, niece or nephew., grandparent, grandchild, father-in-law,, mother-in-law, sOn-in-law, daughter-iri4aw,; stepfathef. pf, st^nipdier, stepson or stepdaughter,stepbrother or stepsister of hai£brother or-half-sister.

^AppUcabJe Party'' means (1) all. executive officers of tiie Di.sclb sing Party listed in Section ILBT'.a if the Disclosing, Party is a coiporatipn: all partners of the Disclosing Party, if the Disclpsing Party isa.geheral partnership; ail general partners and limited partners of the Disclosing Party, if the Disclosing Parfy is a h'mited Partnership; all managers,, managing members.and members pf the Disclosing Party> if the Disclosing Partyis a limited liability company; (2) all principal officers of we.'Djsclosibg Pai^i^d¹ (i^any pe"fSp>having more than: a 7.5 percent ownership interest iii the Disclosing'Party, ^principal'officers"'ft chief .operating officer, executivedirebtori chief financial officer,, treasurer or secrctafybf a legal entity or any person exercising similar authority.

'Does, die Disclosing Party pf.any ''Appljcabje Party⁵' 'or any Spouse of Domestic Partner thereof currently ftavcja ''familial reiafionship'' with an ejected city official or department' head?

[ ] Yes [/) No

If yes, please identify below (l)'thef^eand tide pf such pefsph; (2),thename of die legal entity to "which suchpersph is connected; (3) the name and title of the elected cityofficial, or department head tp whom such.' person has a familial feiationshipi.and (4) the precise nature pf such fajfiiliaj Relationship.

Page 13 of 13

CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT

SECTION I -- GENERAL INFORMATION

A. Legal name of the Disclosing Party submitting this EDS. Include d/b/a/ if applicable: NHS Redevelopment Corporation

Check ONE of the following three boxes.

Indicate whether the Disclosing Party submitting this EDS is:

1. [ ] the Applicant

2. \/\ a legal entity holding a direct or indirect interest in the Applicant. State the legal name of the Applicant in which the Disclosing Party holds an interest: 79th Street Limited Partnership_

3. [ ] a legal entity with a right of control (see Section II.B.l.) State the legal name of the entity in which the Disclosing Party holds a right of control:_

B. Business address of the Disclosing Party: 1279 N. Milwaukee Ave. _

Chicago, IL 60622

(773)341-3174 (773)329-4120 ddixon@nhschicago.org C. Telephone:_Fax:_Email:_

Deborah L. Dixon D. Name of contact person:_

E. Federal Employer Identification No. (if you have one):

F. Brief description of contract, transaction or other undertaking (referred to below as the "Matter") to which this EDS pertains. (Include project number and location of property, if applicable): Withdrawal of Neal Stein from the 79th Street Limited Partnership ownership in the Wrightwood Senior Apartments project, 2815 W. 79th Street, an 85-unit senior mixed-income housing development which was financed with a HOME loan and a TIF grant.

Department of Housing and Economic Development

G. Which City agency or department is requesting this EDS?_

If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:

Specification #_and Contract #_

Ver. 09-01-10

Page 1 of 13

SECTION II -- DISCLOSURE OF OWNERSHIP INTERESTS

A. NATURE OF THE DISCLOSING PARTY

1. Indicate the nature of the Disclosing Party:

[ ] Person [ ]

[ ] Publicly registered business corporation [ ]

[ ] Privately held business corporation [ ]

[ ] Sole proprietorship ^

[ ] General partnership (Is [ ] Limited partnership

[ ] Trust [ ]

Limited liability company Limited liability partnership Joint venture

Not-for-profit corporation

the not-for-profit corporation also a 501(c)(3))?

[/Yes []No Other (please specify)

2. For legal entities, the state (or foreign country) of incorporation or organization, if applicable: Illinois

3. For legal entities not organized in the State of Illinois: Has the organization registered to do business in the State of Illinois as a foreign entity?

[]Yes []No f/N/A

B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:

Name Title See attached list of Board of Directors and Officers

NHS Redevelopment Corporation disclosing

Neighborhood Housing Services of Chicago, Inc. Sole Member

Page 2 of 13

interest of a member or manager in a limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If hone, state "None." NOTE: Pursuant to Section 2-154-030 of the Municipal Code of Chicago ("Municipal Code"), the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.

Name Business Address Percentage Interest in the

Disclosing Party

N/A

SECTION III - BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS

Has the Disclosing Party had a "business relationship," as defined in Chapter 2-156 of the Municipal Code, with any City elected official in the 12 months before the date this EDS is signed?

[]Yes |/[No

If yes, please identify below the name(s) of such City elected official(s) and describe such relationship(s):

SECTION IV - DISCLOSURE OF SUBCONTRACTORS AND OTHER RETAINED PARTIES

"Lobbyist" means any person or entity who undertakes to influence any legislative or administrative action on behalf of any person or entity other than: (1) a not-for-profit entity, on an unpaid basis, or (2) himself. "Lobbyist" also means any person or entity any part of whose duties as an employee of another includes undertaking to influence any legislative or administrative action.

If the Disclosing Party is uncertain whether a disclosure is required under this Section, the Disclosing Party must either ask the City whether disclosure is required or make the disclosure.

Page 3 of 13

Name (indicate whether Business Relationship to Disclosing Party Fees (indicate whether retained or anticipated Address (subcontractor, attorney, paid or estimated.) NOTE:

to be retained) lobbyist, etc.) "hourly rate" or "t.b.d." is

not an acceptable response.

(Add sheets if necessary)

f/ Check here if the Disclosing Party has not retained, nor expects to retain, any such persons or entities. SECTION V - CERTIFICATIONS

A. COURT-ORDERED CHILD SUPPORT COMPLIANCE

Has any person who directly or indirectly owns 10% or more of the Disclosing Party been declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?

[ ] Yes [ ] No lyfNo person directly or indirectly owns 10% or more of the

Disclosing Party.

If "Yes," has the person entered into a court-approved agreement for payment of all support owed and is the person in compliance with that agreement?

[]Yes []No

B. FURTHER CERTIFICATIONS

Page 4 of 13

2. The Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons or entities identified in Section II.B.l. of this EDS:

a. are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from any transactions by any federal, state or local unit of government;

d. have not, within a five-year period preceding the date of this EDS, had one or more public transactions (federal, state or local) terminated for cause or default; and

3. The certifications in subparts 3, 4 and 5 concern:

the Disclosing Party;

Page 5 of 13

c. made an admission of such conduct described in a. or b. above that is a matter of record, but have not been prosecuted for such conduct; or

d. violated the provisions of Municipal Code Section 2-92-610 (Living Wage Ordinance).

7. If the Disclosing Party is unable to certify to any of the above statements in this Part B (Further Certifications), the Disclosing Party must explain below:

N/A

Page 6 of 13

If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.

C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION

1. The Disclosing Party certifies that the Disclosing Party (check one) [ ] is $ is not

a "financial institution" as defined in Section 2-32-455(b) of the Municipal Code.

2. If the Disclosing Party IS a financial institution, then the Disclosing Party pledges:

If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.

D. CERTIFICATION REGARDING INTEREST IN CITY BUSINESS

Any words or terms that are defined in Chapter 2-156 of the Municipal Code have the same meanings when used in this Part D.

[]Yes y[No

NOTE: If you checked "Yes" to Item D.I., proceed to Items D.2. and D.3. If you checked "No" to Item D.I., proceed to Part E.

Page 7 of 13

Does the Matter involve a City Property Sale?

[]Yes [/[No

3. If you checked "Yes" to Item D.I., provide the names and business addresses of the City officials or employees having such interest and identify the nature of such interest:

Name Business Address Nature of Interest

N/A

4. The Disclosing Party further certifies that no prohibited financial interest in the Matter will be acquired by any City official or employee.

E. CERTIFICATION REGARDING SLAVERY ERA BUSINESS

1. The Disclosing Party verifies that the Disclosing Party has searched any and all records of the Disclosing Party and any and all predecessor entities regarding records of investments or profits from slavery or slaveholder insurance policies during the slavery era (including insurance policies issued to slaveholders that provided coverage for damage to or injury or death of their slaves), and the Disclosing Party has found no such records.

_2. The Disclosing Party verifies that, as a result of conducting the search in step 1 above, the

Page 8 of 13

SECTION VI - CERTIFICATIONS FOR FEDERALLY FUNDED MATTERS

A. CERTIFICATION REGARDING LOBBYING

4. The Disclosing Party certifies that either: (i) it is not an organization described in section 501(c)(4) of the Internal Revenue Code of 1986; or (ii) it is an organization described in section 501(c)(4) of the Internal Revenue Code of 1986 but has not engaged and will not engage in "Lobbying Activities".

Page 9 of 13

B. CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPORTUNITY

Is the Disclosing Party the Applicant?

[]Yes L/jNo If "Yes," answer the three questions below:

1. Have you developed and do you have on file affirmative action programs pursuant to applicable federal regulations? (See 41 CFR Part 60-2.)

[ ] Yes [ ] No

[]Yes []No

3. Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?

[ ] Yes [ ] No

If you checked "No" to question 1. or 2. above, please provide an explanation:

SECTION VII - ACKNOWLEDGMENTS, CONTRACT INCORPORATION, COMPLIANCE, PENALTIES, DISCLOSURE

The Disclosing Party understands and agrees that:

B. The City's Governmental Ethics and Campaign Financing Ordinances, Chapters 2-156 and 2-164 of the Municipal Code, impose certain duties and obligations on persons or entities seeking City contracts, work, business, or transactions. The full text of these ordinances and a training program is available on line at www.citvofchicaRo.org/Ethics, and may also be obtained from the City's Board of Ethics, 740 N.

Page 10 of 13

Sedgwick St., Suite 500, Chicago, IL 60610, (312) 744-9660. The Disclosing Party must comply fully with the applicable ordinances.

E. The information provided in this EDS must be kept current. In the event of changes, the Disclosing Party must supplement this EDS up to the time the City takes action on the Matter. If the Matter is a contract being handled by the City's Department of Procurement Services, the Disclosing Party must update this EDS as the contract requires. NOTE: With respect to Matters subject to Article I of Chapter 1-23 of the Municipal Code (imposing PERMANENT INELIGIBILITY for certain specified offenses), the information provided herein regarding eligibility must be kept current for a longer period, as required by Chapter 1-23 and Section 2-154-020 of the Municipal Code.

The Disclosing Party represents and warrants that:

Page 11 of 13

NOTE: If the Disclosing Party cannot certify as'to any of the items in F.l., F.2. or F.3. above, an explanatory statement must be attached to this EDS.

CERTIFICATION

NHS Redevelopment Corporation

(Print or type name of Disclosing Party)

James K. Wheaton

(Print or type name of person signing)

Authorized Signatory

(Print or type title of person signing)

Commission expires: £ -fJL' *&£>IO^ \ ^COMwKll^

Page 12 of 13

CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT

APPENDIX A

FAMILIAL RELATIONSHIPS WITH ELECTED CITY OFFICIALS AND DEPARTMENT HEADS

Under Municipal Code Section 2-154-015, the Disclosing Party must disclose whether such Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently has a "familial relationship" with any elected city official or department head. A "familial relationship" exists if, as of the date this EDS is signed, the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof is related to the mayor, any alderman, the city clerk, the city treasurer or any city department head as spouse or domestic partner or as any of the following, whether by blood or adoption: parent, child, brother or sister, aunt or uncle, niece or nephew, grandparent, grandchild, father-in-law, mother-in-law, son-in-law, daughter-in-law, stepfather or stepmother, stepson or stepdaughter, stepbrother or stepsister or half-brother or half-sister.

"Applicable Party" means (1) all executive officers of the Disclosing Party listed in Section E.B.l.a., if the Disclosing Party is a corporation; all partners of the Disclosing Party, if the Disclosing Party is a general partnership; all general partners and limited partners of the Disclosing Party, if the Disclosing Party is a limited partnership; all managers, managing members and members of the Disclosing Party, if the Disclosing Party is a limited liability company; (2) all principal officers of the Disclosing Party; and (3) any person having more than a 7.5 percent ownership interest in the Disclosing Party. "Principal officers" means the president, chief operating officer, executive director, chief financial officer, treasurer or secretary of a legal entity or any person exercising similar authority.

Does the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently have a "familial relationship" with an elected city official or department head?

[ ] Yes [/] No

Page 13 of 13

NHS Redevelopment Corporation

DIRECTORS 2010-2011

The NHS Redevelopment Corporation by-laws establish a variable range of Directors of the Corporation at a minimum of eleven (11) and a maximum of sixteen (16).

BETTYE BAKER-HOUSTON, Secretary Community Resident

BEN GILLSPIE

Chase Bank

VACANT, Vice President

KRISTINE JURMU, President Bank of America

CHRISTINE KOLB

Urban Land Institute

ROBERT MCGHEE US Bank

FLOYD MINOR

Community Resident

STEVE QUASNY

Harris Bank

JOHN RUSH

Cara Program - CleanSlate

DANIEL SIADAK

Bank of America

ADRIENNE WHITNEY

Community Resident

JUDY ZABA

Community Resident

Legislation Text

Legislation Details

Legislation Details (With Text)